Multidimensional impact of severe mental illness on family members: systematic review

Objective The impact of severe mental illnesses (SMIs) is not limited to the person with the illness but extends to their family members and the community where the patient comes from. In this review, we systematically analyse the available evidence of impacts of SMI on family members, including par...

Full description

Saved in:
Bibliographic Details
Main Authors: Wubalem Fekadu, Awoke Mihiretu, Tom K J Craig, Abebaw Fekadu
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e032391.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850173351987773440
author Wubalem Fekadu
Awoke Mihiretu
Tom K J Craig
Abebaw Fekadu
author_facet Wubalem Fekadu
Awoke Mihiretu
Tom K J Craig
Abebaw Fekadu
author_sort Wubalem Fekadu
collection DOAJ
description Objective The impact of severe mental illnesses (SMIs) is not limited to the person with the illness but extends to their family members and the community where the patient comes from. In this review, we systematically analyse the available evidence of impacts of SMI on family members, including parents, grandparents, siblings, spouses and children.Data sources PubMed, PsycINFO, Embase and Global Index Medicus were searched from the inception of each database up to 9 November 2019. We also did manual searches of grey literature.Eligibility criteria We included studies that assessed the impacts of SMI on any family member. We excluded studies in admitted clinics and acute wards to rule out the acute effect of hospitalisation.Data extraction Two reviewers extracted data independently using the Cochrane handbook guideline for systematic reviews and agreed on the final inclusion of identified studies.Risk of bias The quality of the included studies was assessed using effective public health practice project quality assessment tool for quantitative studies.The review protocol was registered in the PROSPERO database.Results We screened a total of 12 107 duplicate free articles and included 39 articles in the review. The multidimensional impact of SMI included physical health problems (sleeplessness, headache and extreme tiredness.), psychological difficulties (depression and other psychological problems) and socioeconomic drift (less likely to marry and higher divorce rate and greater food insecurity). Impacts on children included higher mortality, poor school performance and nutritional problems. However, the quality of one in five studies was considered weak.Conclusions Our review indicated a high level of multidimensional impact across multiple generations. The serious nature of the impact calls for interventions to address the multidimensional and multigenerational impact of SMI, particularly in low/middle-income countries. Given the relatively high number of studies rated methodologically weak, more robust studies are indicated.PROSPERO registration number CRD42018064123.
format Article
id doaj-art-d62c2de1a61e4439b4ad055025832faa
institution OA Journals
issn 2044-6055
language English
publishDate 2019-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-d62c2de1a61e4439b4ad055025832faa2025-08-20T02:19:51ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-032391Multidimensional impact of severe mental illness on family members: systematic reviewWubalem Fekadu0Awoke Mihiretu1Tom K J Craig2Abebaw Fekadu3Department of Psychiatry, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Health Services and Population Research, King`s College London, London, London, UKNIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, UKObjective The impact of severe mental illnesses (SMIs) is not limited to the person with the illness but extends to their family members and the community where the patient comes from. In this review, we systematically analyse the available evidence of impacts of SMI on family members, including parents, grandparents, siblings, spouses and children.Data sources PubMed, PsycINFO, Embase and Global Index Medicus were searched from the inception of each database up to 9 November 2019. We also did manual searches of grey literature.Eligibility criteria We included studies that assessed the impacts of SMI on any family member. We excluded studies in admitted clinics and acute wards to rule out the acute effect of hospitalisation.Data extraction Two reviewers extracted data independently using the Cochrane handbook guideline for systematic reviews and agreed on the final inclusion of identified studies.Risk of bias The quality of the included studies was assessed using effective public health practice project quality assessment tool for quantitative studies.The review protocol was registered in the PROSPERO database.Results We screened a total of 12 107 duplicate free articles and included 39 articles in the review. The multidimensional impact of SMI included physical health problems (sleeplessness, headache and extreme tiredness.), psychological difficulties (depression and other psychological problems) and socioeconomic drift (less likely to marry and higher divorce rate and greater food insecurity). Impacts on children included higher mortality, poor school performance and nutritional problems. However, the quality of one in five studies was considered weak.Conclusions Our review indicated a high level of multidimensional impact across multiple generations. The serious nature of the impact calls for interventions to address the multidimensional and multigenerational impact of SMI, particularly in low/middle-income countries. Given the relatively high number of studies rated methodologically weak, more robust studies are indicated.PROSPERO registration number CRD42018064123.https://bmjopen.bmj.com/content/9/12/e032391.full
spellingShingle Wubalem Fekadu
Awoke Mihiretu
Tom K J Craig
Abebaw Fekadu
Multidimensional impact of severe mental illness on family members: systematic review
BMJ Open
title Multidimensional impact of severe mental illness on family members: systematic review
title_full Multidimensional impact of severe mental illness on family members: systematic review
title_fullStr Multidimensional impact of severe mental illness on family members: systematic review
title_full_unstemmed Multidimensional impact of severe mental illness on family members: systematic review
title_short Multidimensional impact of severe mental illness on family members: systematic review
title_sort multidimensional impact of severe mental illness on family members systematic review
url https://bmjopen.bmj.com/content/9/12/e032391.full
work_keys_str_mv AT wubalemfekadu multidimensionalimpactofseverementalillnessonfamilymemberssystematicreview
AT awokemihiretu multidimensionalimpactofseverementalillnessonfamilymemberssystematicreview
AT tomkjcraig multidimensionalimpactofseverementalillnessonfamilymemberssystematicreview
AT abebawfekadu multidimensionalimpactofseverementalillnessonfamilymemberssystematicreview